实用医学杂志
實用醫學雜誌
실용의학잡지
THE JOURNAL OF PRACTICAL MEDICINE
2014年
21期
3395-3397
,共3页
俞文华%朱强%董晓巧%张祖勇%车志豪%刘群杰%王昊%杜权%杨定博%沈永锋%杜垣锋
俞文華%硃彊%董曉巧%張祖勇%車誌豪%劉群傑%王昊%杜權%楊定博%瀋永鋒%杜垣鋒
유문화%주강%동효교%장조용%차지호%류군걸%왕호%두권%양정박%침영봉%두원봉
三叉神经痛%球囊%压迫
三扠神經痛%毬囊%壓迫
삼차신경통%구낭%압박
Trigeminal neuralgia%Balloon%Compression
目的：总结经皮穿刺球囊压迫半月神经节手术（PBC）治疗顽固性三叉神经痛的临床效果。方法：对我科自2009年10月至2013年5月采用 PBC 方法治疗的452例顽固性三叉神经痛患者的临床资料进行回顾性总结，其中80岁以上高龄患者125例，疼痛累及第Ⅰ支70例；PBC在X线监视下应用Hartel前入法、通过鞘管导入4号Fogarty 球囊进入Meckel腔压迫半月节，术后对患者进行随访及疗效观察。结果：本组患者术后住院3～9 d，平均6．1 d，无严重手术并发症发生。432例术后疼痛完全缓解，总有效率为97．8％，术后患者感患侧面部麻木385例（85．2％），张口咀嚼略乏力248例（54．9％），口角疱疹139例（30．8％），复视2例（0．4％），症状多于1～6个月内好转或消失。平均随访23．5个月，本组疼痛复发率约为10．2％（46例）。结论：PBC是治疗顽固性三叉神经痛十分有效的微创手术方法，尤其对于高危或疼痛累及第Ⅰ支、各种手段治疗后复发的患者更有优势。
目的：總結經皮穿刺毬囊壓迫半月神經節手術（PBC）治療頑固性三扠神經痛的臨床效果。方法：對我科自2009年10月至2013年5月採用 PBC 方法治療的452例頑固性三扠神經痛患者的臨床資料進行迴顧性總結，其中80歲以上高齡患者125例，疼痛纍及第Ⅰ支70例；PBC在X線鑑視下應用Hartel前入法、通過鞘管導入4號Fogarty 毬囊進入Meckel腔壓迫半月節，術後對患者進行隨訪及療效觀察。結果：本組患者術後住院3～9 d，平均6．1 d，無嚴重手術併髮癥髮生。432例術後疼痛完全緩解，總有效率為97．8％，術後患者感患側麵部痳木385例（85．2％），張口咀嚼略乏力248例（54．9％），口角皰疹139例（30．8％），複視2例（0．4％），癥狀多于1～6箇月內好轉或消失。平均隨訪23．5箇月，本組疼痛複髮率約為10．2％（46例）。結論：PBC是治療頑固性三扠神經痛十分有效的微創手術方法，尤其對于高危或疼痛纍及第Ⅰ支、各種手段治療後複髮的患者更有優勢。
목적：총결경피천자구낭압박반월신경절수술（PBC）치료완고성삼차신경통적림상효과。방법：대아과자2009년10월지2013년5월채용 PBC 방법치료적452례완고성삼차신경통환자적림상자료진행회고성총결，기중80세이상고령환자125례，동통루급제Ⅰ지70례；PBC재X선감시하응용Hartel전입법、통과초관도입4호Fogarty 구낭진입Meckel강압박반월절，술후대환자진행수방급료효관찰。결과：본조환자술후주원3～9 d，평균6．1 d，무엄중수술병발증발생。432례술후동통완전완해，총유효솔위97．8％，술후환자감환측면부마목385례（85．2％），장구저작략핍력248례（54．9％），구각포진139례（30．8％），복시2례（0．4％），증상다우1～6개월내호전혹소실。평균수방23．5개월，본조동통복발솔약위10．2％（46례）。결론：PBC시치료완고성삼차신경통십분유효적미창수술방법，우기대우고위혹동통루급제Ⅰ지、각충수단치료후복발적환자경유우세。
Objective To evaluate the clinical effects of percutaneous micro-balloon compression (PBC) trigeminal ganglion for the treatment refractory trigeminal neuralgia. Methods Surgical results of 452 patients with trigeminal neuralgia treated by PBC from October 2009 to May 2013 were analyzed retrospectively. 125 cases aged over 80 years old and 70 cases′ pain belongs to the first branch neuralgia. Such procedures as Meckle′s cave cannulated with No.4 Forgarty catheter and the balloon inflated and compressed the gasserian ganglion monitored by X-ray were observed by PBC. Follow-up interview and curative effects were recorded. Results The average hospitalization was 6.1 days. Among them, 432(95.6%) cases had immediate relief from pain. The overall pain relief rate was 97.8% in our group without serious surgical complications. Postoperative complications include hemifacial numbness in 385 patients (85.2%), mild masseter muscle weakness in 248 patients (54.9%), diplopia in 2 patients. All symptoms relived or disappeared within 1 ~ 6 months. The average follow-up intervier period is 23.5 months. The recurrence rate is 10.2% (46 cases). Conclusion PBC is a safe and effective method with high pain relief rate in the treatment of refractory trigeminal neuralgia , especially for the treatment of the high risk patients , patients with recurrent symptoms or the patients suffered from the first branch neuralgia.
